The nose is the subject of many sayings. Measurements can be taken on the nose or on an object directly below the nose. You may be reminded to keep your nose clean and not to interfere in other people’s business.
While the nose is usually the focus of these idioms, it can also be affected by medical conditions, such as nasal polyps. These are soft, painless, noncancerous growths on the lining of the nose or sinuses that hang down like teardrops or grapes.
Nasal polyps can form anywhere in the sinuses or nasal passages. But they most commonly appear in the eyes, nose, and areas near the cheekbones where the sinuses drain into the nose through winding passages.
Here’s what you need to know about these little growths.
What causes nasal polyps?
Nasal polyps are often caused by chronic inflammation of the nasal passages. This is why people with chronic sinusitis are at increased risk of developing nasal polyps. Chronic sinusitis is swollen and inflamed sinuses for more than 12 weeks. This causes the lining of the nose to produce more mucus, and the swollen lining prevents drainage.
People with asthma, allergies, drug sensitivities, or certain immune disorders are also at increased risk of developing nasal polyps.
Scientists don’t yet fully understand why certain conditions and inflammation trigger polyps in some people but not others. Nasal polyps can occur at any age, but are most common in young and middle-aged people.
What are the common symptoms of nasal polyps?
A person may have nasal polyps without knowing it, especially small ones. Large or multiple polyps can cause nasal congestion, impaired sense of smell and taste, reduced airflow, and recurring sinus infections.
Some people with nasal polyps are intolerant to over-the-counter pain medications such as ibuprofen and naproxen.
Can nasal polyps cause health complications?
Nasal polyps can cause complications because they block airflow, fluid drainage, and long-term inflammation as they develop. For some people, they can cause asthma worsening or structural changes in the sinuses.
Many people with nasal polyps experience recurring sinus infections. This increases antibiotic exposure and can lead to Clostridium difficile (also called Clostridium difficile), a potentially serious gastrointestinal infection.
How are nasal polyps treated?
The goal of nasal polyps treatment is to shrink or eliminate the polyps. Medication is usually the first approach. Sometimes surgery may be needed, but it may not provide a permanent solution because polyps tend to recur.
Nasal steroids and budesonide rinses can reduce swelling and irritation. These treatments may shrink the polyps or eliminate them entirely.
If you have nasal polyps and chronic sinusitis, your health care team may give you an injection called dupilumab (commonly called Dupixent) to treat your condition. This biologic drug can reduce the size of nasal polyps and relieve nasal congestion. It is usually prescribed by an allergist and can be used at home.
Nasal polyps in children are usually treated with topical medications and dupilumab.
Can nasal polyps be prevented?
By reducing inflammation in your nose and sinuses, you may be able to reduce your chances of developing nasal polyps or of polyps coming back after treatment.
Start by following these tips:
–Manage allergies and asthma. Follow your healthcare team’s treatment recommendations. If your symptoms are not well controlled, ask about changes to your treatment plan.
–Avoid nasal irritants. If possible, avoid breathing in airborne substances that may cause swelling or irritation in the nose and sinuses, such as allergens or substances that cause allergies; tobacco smoke; chemical fumes; dust; and fine debris.
— Maintain good hygiene habits. Wash your hands regularly and thoroughly. This is one of the best ways to prevent bacterial and viral infections that can cause inflammation of the nasal passages and sinuses.
— Humidify your home. Using a humidifier may help moisten your airways, improve the flow of mucus in your sinuses, and help prevent blockage and inflammation. Clean your humidifier daily to eliminate bacterial growth.
–Use nasal rinses. Rinse your nose with a saline spray or nasal rinse. This improves mucus flow and removes allergens and other irritants.
How are nasal polyps diagnosed?
Your healthcare team can usually make a diagnosis based on your answers to questions about your symptoms, a general physical exam, and a nose exam. Polyps can be seen with the help of a simple illuminated instrument called a nasal endoscope.
They may also recommend skin testing to determine if allergies are causing chronic inflammation. A skin prick test involves placing tiny drops of the allergen into the skin of your forearm or upper back. Your healthcare team will watch your skin for signs of an allergic reaction. If a skin test is not available, blood tests can screen for specific antibodies to various allergens.
Talk to your healthcare team if you have recurring sinus infections, have infections that last longer than 12 weeks, have an impaired sense of smell or taste, or have trouble breathing through your nose.
John Wheeler Jr., MD, is an allergist at Allergy & Asthma in La Crosse, Wisconsin.
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